Differing trends in fall-related fracture and non-fracture injuries in older people with and without dementia

ObjectivesTo explore the impact of dementia on the trends in fall-related fracture and non-fracture injuries for older people.MethodsIndividuals aged ≥65 years who were admitted to a NSW hospital for at least an over-night stay for a fall-related injury from 2003 to 2012 were identified. Age-standardised hospitalisation rates, length of stay, access to in-hospital rehabilitation, 30-day and 1-year mortality were examined. Annual percentage change (PAC) over time was calculated using negative binomial regression.ResultsOf the 228,628 fall-related injury hospitalisations, 20.6% were for people with dementia. People with dementia were more likely to be admitted with a hip fracture, and less likely to be admitted with a fracture of the forearm/wrist, and received less in-hospital rehabilitation than people without dementia. Fall-related hip-fracture rates for people with dementia decreased by 4.2% (95%CI −5.6 to −2.7, p < 0.001) per annum; there was no change over time for people without dementia (PAC-0.2%; 95%CI −0.8 to 0.5, p = 0.643). Rates for other fractures decreased by 1.2% (95%CI −1.9 to −0.5, p < 0.001) per annum in people with dementia, while rates increased by 2.2% (95%CI 1.9–2.5, p < 0.001) for people without dementia. By contrast, non-fracture injuries including traumatic brain injury increased significantly for both people with and without dementia.ConclusionRates of fall-related fracture and non-fracture hospitalisations for people with dementia remain higher than for those without dementia. However, fall-related fracture hospitalisation rates have decreased for people with dementia, while there has not been a corresponding decrease in people without dementia.     

儿童埋伏牙多层螺旋CT检查中的辐射剂量评价

目的 探讨适合儿童埋伏牙多层螺旋CT(MSCT)检查的低剂量曝光条件。方法 80例经16层螺旋CT检查出埋伏牙的患儿,按曝光量不同分为5、25、125及250mAs4组,由放射科2名正主任医师及3名副主任医师采用双盲法评价图像质量,并记录不同毫安秒扫描时的加权CT剂量指数(CTDI_w)、剂量长度乘积(DLP),使用SAS9.1统计分析系统进行统计学处理。结果 4组的扫描图像均能准确显示埋伏牙结构及其相邻关系。5mAs扫描组在牙槽突骨小梁及牙龈等周围软组织的分辨能力较25、125及250mAs组下降,但仍能满足诊断要求。5mAs组CTDI_w值及DLP值仅为250mAs组的2%。结论 5mAs的MSCT低剂量扫描可以满足儿童埋伏牙诊断需要,减少了患儿接受的辐射剂量。     

MRI对颅内孤立性纤维瘤/血管外皮细胞瘤与血管瘤型脑膜瘤的鉴别诊断价值

目的 探讨MRI对颅内孤立性纤维瘤/血管外皮细胞瘤(SFT/HPC)与血管瘤型脑膜瘤(AM)的鉴别诊断价值.方法 选取并分析经手术病理证实的SFT/HPC与AM患者的临床特征及MRI征象,应用ROC曲线、多因素Logistic回归模型,分析其对SFT/HPC及AM的独立预测因素及鉴别诊断效能.结果 计量资料进行￡检验表...     

64层螺旋CT血管造影诊断颅内动脉瘤的价值

目的探讨64层螺旋CT血管造影（CT angiography，CTA）对颅内动脉瘤的诊断价值。方法41例颅内动脉瘤患者行64层螺旋CT增强扫描。用高压注射器经肘正中静脉注射对比剂（碘海醇，350mgI／mL）100mL，注射速率3mL／s。在工作站上对原始数据进行重建，包括容积重建、曲面重建、多平面重建、最大密度投影和表面覆盖成像。结果41例患者检出47个动脉瘤。结论64层螺旋CTA是诊断颅内动脉瘤的安全、快速、无创、有效的方法，为临床治疗提供依据。     

CT导引下胸内肿物穿刺活检22例临床分析

目的探讨CT导引下的胸壁穿刺活检对胸内占位性病变的诊断价值。方法对22例行CT导引下胸壁穿刺活检的病例进行总结分析,该组患者均为CT扫描发现胸部肿物而难以明确诊断者。结果所有病例均穿刺成功并获组织学和细胞学材料,送检共发现19例为恶性病变;组织学诊断有18例为恶性病变,细胞学诊断有5例为恶性病变。穿刺中和穿刺后,发生气胸2例、痰中带血1例。结论CT导引下的胸壁穿刺活检是一种有效的诊断手段,自动切割针可以较好地获得组织学标本,细胞学和组织学检查互补可提高检出率。     

螺旋CT对周围型小细胞肺癌的诊断价值

目的:探讨周围型小细胞肺癌(PSCLC)的CT表现及其诊断价值.方法:回顾性分析53例经皮肺穿刺活检或手术病理证实的PSCLC患者的CT表现.结果:53例中,肺内病灶呈结节状39例,团块状11例,片絮状3例;结节状或团块状病灶表现为边缘清晰的小波浪状或浅分叶状.49例伴有肺门或/和纵隔淋巴结肿大,其中39例肺门或和纵隔肿大淋巴结的大小超过肺内肿瘤,35例肿大的淋巴结融合成块而呈现冰冻纵隔改变.结论:周围型小细胞肺癌的CT表现有一定的特征性,螺旋CT扫描是诊断PSCLC的有效检查方法.